Sonrisa Cchc Capitation LLC

NPI #1053988204 in Chicago, Illinois

Provider Information

NPI Number: 1053988204
Entity Type: Organization
Organization Name: Sonrisa Cchc Capitation LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 7, 2021
Last Updated: Jun 7, 2021

Practice Location

Address: 9718 S HALSTED ST
City: Chicago
State: Illinois
ZIP Code: 60628-1007
Phone: (872) 703-3032

Authorized Official

Name: JASON K KORKUS, DDS
Title: OWNER/PRESIDENT
Phone: (312) 722-6460

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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